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• W2009455250 abstract "Background: Many HIV care and treatment programs in resource-limited settings rely on clinical and immunologic monitoring of antiretroviral therapy (ART), but accuracy of this strategy to detect virologic failure (VF) among children has not been evaluated. Methods: A cross-sectional sample of HIV-infected children aged 1-16 years on ART ≥6 months receiving care at a Tanzanian referral center underwent clinical staging, CD4 lymphocyte measurement, plasma HIV-1 RNA level, and complete blood count. Associations with VF (HIV-1 RNA ≥400 copies/mL) were determined utilizing bivariable and multivariate analyses; accuracy of current clinical and immunologic guidelines in identifying children with VF was assessed. Findings: Of 206 children (median age 8.7 years, ART duration 2.4 years), 65 (31.6%) demonstrated VF at enrollment. Clinical and immunological criteria identified 2 (3.5%) of 57 children with VF on first-line therapy, exhibiting 3.5% sensitivity and 100% specificity. VF was associated with younger age, receipt of nevirapine vs. efavirenz-based regimen, CD4% < 25%, and physician documentation of maladherence (P < 0.05 on bivariable analysis); the latter 2 factors remained significant on multivariate logistic regression. Interpretation: This study demonstrates poor performance of clinical and immunologic criteria in identifying children with virologic failure. Affordable techniques for measuring HIV-1 RNA level applicable in resource-limited settings are urgently needed." @default.
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• W2009455250 date "2010-08-01" @default.
• W2009455250 modified "2023-10-10" @default.
• W2009455250 title "Predicting Virologic Failure Among HIV-1-Infected Children Receiving Antiretroviral Therapy in Tanzania: a Cross-Sectional Study" @default.
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• W2009455250 doi "https://doi.org/10.1097/qai.0b013e3181cf4882" @default.
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